Reflections

The first birth was fast, over before I knew it, before I could even shake. And very special—of course it would be special.

The second two babies I caught happened in quick succession in the same morning. One was born at 9:55 am and the other was born at 11:09 am. The first a boy, the second a girl, both beautiful and vigorous and screaming their heads off, Apgars 9/9. Both mothers were unmedicated, which is something I see so infrequently in the hospital these days, and it was so beautiful to watch labor unfold without drugs, without the mothers numb from the waist up and watching TV or filing their nails, oblivious while their bodies heaved through contraction after contraction. No, these two mothers were certainly not oblivious, and it was gorgeous to watch them handle their pain—inspiring, and beautiful in how different it was, and an honor to help them through it.

The first mother was loud. She moaned, she groaned, she flapped her hand up and down quickly in a sharp, flicking motion, almost like she was trying to flick away the pain. She was a multip, and her labor was like sledding downhill on a snowy day, no way to stop it or slow it down. Her partner was downstairs parking the car, and by the time he came upstairs, the baby had already been born. Vigorous, like I said, but so small for a full term baby—only 4 lbs. 11 ounces. And then she bled, more than I was expecting (although not actually a hemorrhage), but certainly enough to scare me. My preceptor was out of the room as the placenta was delivered and I was mildly panicking; when she came back in, she set me straight (no, that’s not a hemorrhage, but yes, that’s heavy bleeding), and she supported my decision to administer methergine, which I’d already asked the nurse to fetch.

The other new mother that day was very young, a teenager, but very mature for her age, and nearly silent throughout her labor. She had her partner on one side of her, and her mother on the other, and both of them were incredibly attentive. The mother especially, stroking her hair and saying “mi amor, mi amor” over and over. This woman made noise at the peak of her contractions, soft moaning, but in between her eyes were shut and it looked like she was asleep. Very restful. She was a primip, but everything moved right along for her. She progressed quickly, without complications, and delivered her baby girl after only 49 minutes of pushing. She was gorgeous, 7 lbs exactly, but her arm was flexed in utero, and as her anterior shoulder emerged, she extended her arm and made a nice sized gash in her mother’s labia (otherwise, the perineum was intact!), so there was a bit of a repair to do (and labial, ack!). I was very nervous about the repair, because I do feel like the perineum is one thing, but the labia are something else entirely—more personal and more intimate. If I had a choice in the matter, I’d say lacerate my perineum all you like, but stay away from my labia and clitoris, thank you very much! I was very conscious of the fact that we were repairing a vital, sensitive, sensual part of her body, and I really wanted to make sure we got it right, and I think it went okay. My preceptor did the first stitch, then I did the second, and we switched back and forth like that, putting the pieces of the laceration together like a puzzle.

The fourth baby I caught was the mother’s third child, and you could tell that she knew how tiring the first few months (years?) are. She had an epidural, and was determined to get as much sleep as possible before the birth, almost right up to the moment of the birth. We kept trying to wake her up and encourage her to push, knowing that the baby’s head was right on the perineum, and that as soon as she pushed once or twice, the baby would come out immediately. But she wasn’t interested in pushing, she was interested in sleeping, and the epidural was a very good one, so she slept. And we waited, since the tracing was beautiful and there was absolutely no reason to rush. Finally, when she was ready, she opened her eyes, pushed three times, and gave birth to her baby girl. As the head came out, I checked for a cord as I’ve been taught to do every time, and this time I actually felt one, warm and pulsing. There’s a cord, I said, and my preceptor and I tried to stretch it over the baby’s head, but it wouldn’t quite stretch far enough. It wasn’t tight, though, and there was no reason to cut it, so we just pushed it up over the baby’s shoulder, and delivered the baby through the loop of her own cord, and that was that. Nuchal cord management, without the management, just the joy of not having to cut the cord, and letting the baby get the full advantage of the extra blood flow, which studies have shown is so important in easing the transition between intrauterine and extrauterine life. Once the baby was in the mother’s arms, she was wide awake and so alert, examining all the fingers and toes, looking in the baby’s eyes, cooing at her. This is what she’d been saving her energy for, you could tell. I’m glad she was able to get all that sleep.

Four beautiful births, four beautiful babies. I’m a very lucky student midwife, indeed. And this is so much fun! Can I do this more often?? Can I keep doing this for the rest of my life? Pretty please??